The annual NHS Innovation Expo is always a hotbed of ideas. 2013, for example, saw the launch of the NHS App Library. The response after one year: Improvements in progress. It has been on the verge of closure, but equally appreciated for what the NHS does best: reliable advice. There’s no shortage of commitment in the UK’s giant health provider to digital access and the “engaged user”. Innovation Expo 2014 saw a slew of further initiatives.
Since the start of the Internet, clinicians have constantly undervalued the benefits and overestimated the risks of online health resources for patients (as mentioned here, here, and here). The informed patient uses the Internet to find second opinions, interpret symptoms, seek support, help interpret physicians’ advice, and formulate questions for subsequent visits (according to Ziebland et al.)
NHS Choices is therefore a great starting point in demonstrating how much value digital health can bring to the population. It is the UK’s biggest health portal for curated content and personalised, local information on healthcare providers. It achieved 43 million visitors in January 2014. But that is not where it ends. Choices could be a route to scale for many other healthcare information and data services.
Innovators want to work with NHS Choices because they have ready access to a broad market and a trusted brand. Both are very valuable to entrepreneurs or social innovators seeking to scale a solution or sandbox an idea. NHS Choices is starting to understand the value and power of these third parties. With innovation companies like Health Unlocked and Zesty, Choices is starting to offer additional services to visitors – and faster than it could achieve through in-house development. We talked to Jonathon Carr-Brown, Managing Director of NHS Choices, about access to healthcare and the landscape in innovation collaboration.
MC: How does NHS Choices increase health access for people in the UK?
JC-B: We provide authoritative clinical approved content with the NHS brand on it. This has become the starting point for the health research of millions of citizens in the UK. Then, we point people to high-quality specialist health information from organizations like Cancer Research UK etc. In addition, we provide balanced lifestyle advice on diet and fitness which is being used by millions of people. We haven’t so much solved a problem as provided a structured starting point to help people solve their own health problems. We have 22% of the UK health information market but that shows how much information there is out there. Before we entered the market, I think people may have been looking for a site that helped them navigate the world of health information. Put breast cancer into Google, and you get 209 million references. But in the UK, the second result has the NHS brand on it and you know you can start there with confidence.
MC: How does NHS Choices work with other organizations and innovators to improve health access in the UK?
JC-B: We need to take our user base and start pushing them towards some of the great applications and services that are being created. We have the user base and the brand. We need to exploit that and form a symbiotic relationship with innovators. The future is about personalization and transactions (appointment booking etc.) and we intend to facilitate these areas, not build them ourselves.
“We have the user base and the brand.”
MC: What does the term “health access” mean to you personally?
JC-B: It means a mother with a baby late at night can find information she trusts quickly. It means a carer can share their experiences and maybe a young person can educate themselves about sex. To me, it’s about creating an informed citizen and ultimately saving the NHS because we start using it more efficiently and demanding higher quality. And it’s about appropriately changing the relationship between patients and clincians to something that looks more collaborative.
MC: What’s the biggest problem the UK faces in terms of health access? Where should innovation be concentrated today?
JC-B: The biggest problem is long term conditions. And we need to start aggregating all the wonderful individual digital solutions out there to create coherent, practical digital propositions that encourage individuals to manage their conditions and lives efficiently. Personally, I want to see someone create an app that can examine an individual’s health record and tell them whether they’ve followed the appropriate pathway, had the appropriate checks and been told about clinical trials or the side effects of drugs. We’ve got all the elements. Someone just needs to mash them all together. I’m not sure what the business model would be, but it would be a valuable aid to clinicians and patients.
MC: Can other nations learn anything from the approach taken by NHS Choices?
JC-B: Where to start?! I think the US can learn from us and vice versa and indeed we have strong links with the US government. My overriding lesson is: listen to the user, not the politicians or the civil servants. You can tell the products on NHS Choices that have been driven by political imperatives and those driven by user need. The former, no one uses; the latter, millions use. Content and data are king. If you have good content and data then search engines do the marketing for you. (It is worth noting NHS Choices content is free to the world to use and many nations are now translating it). It helps if you have a National Health Service and a world class brand like the NHS. Lastly, you shouldn’t build everything yourself. Grab the best and aggregate it. NHS Choices will increasingly be doing more of this as it tries to personalize the site and move into a world where people can research and then act e.g. make an appointment with a clinician from the site.